Defines the minimum expectations and behavior for a computable plan definition

Profile of PlanDefinition as a Recommendation Definition for use with CPG Implementation Guide

Defines the minimum expectations for a shareable plan definition for use with computable guideline content. This profile derives from the ShareablePlanDefinition profile defined in the base FHIR specification, and adds support for declaring knowledge representation level and knowledge artifact capabilities.

Profile of PlanDefinition as a Strategy Definition for use with CPG Implementation Guide. Strategies are used to group recommendations together, typically focused on a particular condition or state within the overall guideline or pathway

The actual group observed in a study or groups of groups in an evidence synthesis.

Definition of a population (e.g. for guideline recommendation, clinical study) via the eligibility criteria.

A single evidence for an outcome from a specific study, meta analysis or systematic review.

Description of the a PICO element that knowledge is about. This abstract resource is used as parent for all PICO (population, intervention, comparison, outcome) evidence variables.

Definition of an activity that is part of an intervention in the context of a clinical practice guideline recommendation.

Enforces the minimum information set for the plan definition metadata required by HL7 and other organizations that share and publish plan definitions

Definition of an assessment action.

Definition of a body positioning action as part of a recommended intervention.

Rating of a single outcome (evidence) underlying a clinical practice guideline recommendation

Representation of an evidence-based clinical practice guideline.

Definition of a drug administration action as part of a recommended intervention.

Definition of the outcome used as the observed measured variable for an evidence synthesis.

The actual group of Groups observed in an evidence synthesis.

Collection of all resources that represent a single clinical practice guideline.

Citation of a clinical practice guideline

Description of the intervention element of a PICO construct that evidence is about.

The net effect is the overall expected effect of a recommendation, calculated by an importance-weighted average of the individual outcome effects

Description of the outcome element of a PICO construct that evidence is about.

A single evidence for an outcome from an evidence synthesis.

A recommendation as part of a clinical practice guideline.

Citation of a clinical practice guideline recommendation

Eligibility Criteria for a Clinical Guideline Recommendation

Justification of a clinical guideline recommendation through the underlying evidence and their ratings

Definition of an activity that is part of an intervention in the context of a clinical practice guideline recommendation.

Citation of a study from which evidence is determined.

The actual group observed in a study.

Eligibility Criteria for a clinical study

A single evidence for an outcome from a primary study.

Extension used on PlanDefinition.action to specify a method for combining the actions.

Adds publication status attribute to ArtifactAssessment.

Adds version attribute to Artifact Assessment.

A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

Adds type/value pair to elements of datatype Dosage to express a condition on the dosage.

The quality of the evidence described. The code system used specifies the quality scale used to grade this evidence source while the code specifies the actual quality score (represented as a coded value) associated with the evidence.

The strength of the recommendation assigned to this reference. The code system used specifies the rating scale used to rate this recommendation while the code specifies the actual recommendation rating (represented as a coded value) associated with this recommendation.

Value set for the method used to combine actions in a PlanDefinition.

Action selection behavior with only codes that require at least one action to be performed.

Allergic Dispositions from SNOMED CT

Assessments

Codes for assessment scales (scores etc.)

Body positioning procedure codes from SNOMED CT

Clinical Importance of Outcome

All codes from the Cochrane PICO ontology.

All intervention codes from the Cochrane PICO ontology.

All outcome codes from the Cochrane PICO ontology.

All population codes from the Cochrane PICO ontology.

Episdoe Of Care Type

Current status of a clinical practice guideline recommendation

Stage classification according to systematics

Most important

Mean difference types

Observable Entities from SNOMED CT

Radiologic findings from SNOMED CT

Are the alternatives acceptable for the target population and its implementors?

Summary of most important benefits and harms

Codes from EvidenceCertaintyRating related to certainty of evidence

Codes from EvidenceCertaintyRating related to degree of concern

Degree of consensus reached

How do the different alternatives affect equity?

How feasible will it be to implement the different alternatives? Any issues?

Typical patient preferences and values? Common issues or expected variability?

Issues with costs or resource use? For whom? Cost-benefit analysis? Implementation or other issues?

Ratings for factors that might cause rating up the certainty

Ratings for factors that might cause rating up the certainty

Strength of a clinical guideline recommendation.

Relative effect types

All substance codes from SNOMED CT

Ventilation Observables from SNOMED CT

Code system for the combination of actions in a PlanDefinition.

Codes for clinical guideline recommendation representation missing from other code systems.

Clinical Importance of Outcome

The Cochrane Core ontology describes the entities and concepts that exist in the domain of evidence based healthcare.

The PICO ontology describes questions in evidence based healthcare with the intention of supporting the publishing of evidence as linked data.

The assessment of quality, confidence, or certainty.

GRADE Evidence to Decision (EtD) Framework Certainty Ratings

GRADE Evidence to Decision (EtD) Framework Certainty Type

As part of the project planning for the creation or updating of a guideline, a decision should be made at an early stage about the planned level classification (“S classification”) according to the AWMF’s system of rules (1-3). The S-classification scheme of the AWMF differentiates between the classes S1 treatment recommendation as well as S2e, S2k and S3 guideline. The “S” stands for the extent of the applied systematic approach in the development process of a guideline. Each class thus stands for a specific methodological concept that must be presented in a way that is comprehensible to the users. The choice of class is based on the question of how much effort is appropriate and feasible. The need for legitimacy for the implementation of the guideline (convincing the target group) must be taken into account. When choosing a higher S-classification in the context of updating a guideline, the adaptation to the corresponding methodology has to be considered.

Klassifizierung eines Kontaktes mit einer Gesundheitseinrichtung

Strength of a clinical guideline recommendation.

Types of combining results from a body of evidence (eg. summary data meta-analysis).

All-cause mortality.

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e.V

COVID19 Intensive Care Treatment Guideline (Bundle).

COVID19 Intensive Care Treatment Guideline.

Certainty of evidence rating for mortality outcome of Dexamethasonse application recommendation

Application of Dexamethasone for ventilated patients only

Application of Dexamethasone: 6 mg once per day for 10 days p.o. or i.v. for ventilated COVID-19 patients

Application of Dexamethasone: 6 mg once per day for 10 days (intravenous route)

Application of Dexamethasone: 6 mg once per day for 10 days (oral route)

Citation of Dexamethasone Recommenation from COVID-19 intensive care patients treatment guideline

Dexamethasone in critically ill patients with COVID-19.

Example of an assessment action.

Example of a body positioning action.

Example Certainty Of Evidence Rating

A drug administration that should be performed.

Example of an evidence data set

Example of a cohort in an evidence synthesis

Example of a guideline resource.

Example of a Citation of a clinical practice guideline

Example of an intervention definition.

Example of a net effect estimate

A drug administration that should not be performed.

Example of a organization resource.

Example of an outcome evidence variable.

Example Outcome Evidence Synthesis

Example of a Citation of a clinical practice guideline recommendation

Example of a population element of a PICO construct that evidence is about.

Example of a recommendation justification

An active recommendation plan.

Example Study Citation

Example study cohort of 20 patients

Example of Study Eligbility Criteria

Example Study Outcome Evidence

Example of a clinical practice guideline representation bundle.

Mortality Outcome for Dexamethasone application in hospitalized COVID-19 patients

No Dexamethasone in moderately ill patients with COVID-19.

No Application of Dexamethasone

No application of Dexamethasone for non-ventilated COVID-19 patients

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, not ventilated

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, Ventilated

Study cohort for for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Study eligibility criteria for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Systemic corticosteroids for the treatment of COVID-19

Guideline for therapy of hospitalized COVID-19 patients

Recommendation